Malaria in Pregnant Women

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Malaria is a more serious problem in pregnant women as it can be much more severe and cause complications. If you are pregnant, you are more than ten times more likely to get malaria. It is also more likely to be a severe form of the disease and often fatal.  Complications are also more common in pregnant women and both your baby and your own health will be affected.

There are approximately 10,000 maternal deaths per year in Sub-Saharan Africa due to malaria. You are most at risk if you are in the second trimester and placental malaria is often common. The red blood cells that are infected in the parasite often accumulate in the intervillous space of the placenta and this makes the disease difficult to diagnose because all the parasites are sequestered at this area.

The symptoms of malaria are not always present in pregnant women so if you have a fever, you will be asked about your travel history to rule out the case of malaria. It can cause serious complications in pregnant women because cerebral anaemia is much more common if you are pregnant. You are also more likely to get hypoglycaemia and acute pulmonary oedema.

Your baby will also be affected by malaria and the disease can often result in spontaneous abortion or stillbirth. Your baby is also more likely to be born at a low birth weight and there is more of a chance of inauterine growth retardation.  Malaria can also cause your baby to be born prematurely. Your baby can also contract malaria as it can be passed via the placenta to your baby. This is rare but more likely to occur in babies whose mothers were not immune to the disease. This form of malaria is called congenital malaria and can cause fever, jaundice, anaemia, feeding problems and irritability. This is a big health issue because although the mother is treated for malaria, the medication may not kill the parasites in the foetus.

Treatment is more difficult for pregnant women because some drugs are not licensed to treat malaria in pregnancy. This is due to the fact that there is not enough evidence to decide whether the drug will adversely affect the foetus. Chloroquine and Quinine can be used to treat any pregnant woman who has malaria but Artemisinins can only be used in the second and third trimesters. Pregnant women are also more likely to have a relapse so other combination drugs may have to be used.

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